Powered surgical stapling device platform

ABSTRACT

The present disclosure provides for a surgical instrument which includes a housing and an endoscopic portion extending distally from the housing and defining a first longitudinal axis. The surgical instrument also includes an end effector disposed adjacent a distal portion of the endoscopic portion. The end effector includes an anvil assembly and a cartridge assembly. The anvil assembly is pivotally coupled to the cartridge assembly to be movable from a first actuation position to at least one other second actuation position. The surgical instrument further includes a firing rod having a shaft defining a second longitudinal axis, the shaft having a cam member which is in mechanical cooperation with the anvil assembly and is configured to move the anvil assembly from the first actuation position to the at least one other second actuation position upon rotation of the firing rod about the second longitudinal axis.

BACKGROUND

1. Technical Field

The present disclosure relates to surgical instruments for fasteningbody tissue and, more particularly, to a powered surgical instrumenthaving a firing rod configured to be movable and rotatable to affectrotation, articulation and actuation of portions of the instrument.

2. Background of Related Art

Surgical devices wherein tissue is grasped or clamped between opposingjaw structure and then joined by surgical fasteners are well known inthe art. In some instruments, a knife is provided to cut the tissuewhich has been joined by the fasteners. The fasteners are typically inthe form of surgical staples but two-part polymeric fasteners can alsobe utilized.

Instruments for this purpose may include two elongated members which arerespectively used to capture or clamp tissue. Typically, one of themembers carries a staple cartridge that houses a plurality of staplesarranged in at least two lateral rows while the other member has ananvil that defines a surface for forming the staple legs as the staplesare driven from the staple cartridge. Several instruments includeclamps, handles and/or knobs to affect actuation along with rotation andarticulation of an end effector. Generally, the stapling operation iseffected by cam bars that travel longitudinally through the staplecartridge, with the cam bars acting upon staple pushers to sequentiallyeject the staples from the staple cartridge. Such stapling devices canbe used in open as well as endoscopic and/or laparoscopic surgicalprocedures.

It would be extremely beneficial to provide a powered surgical devicefor use during surgical procedures that can utilize a new and improvedmechanism for articulating and/or actuating the tool tip to automate thestapling process.

SUMMARY

According to one aspect of the present disclosure, a surgical instrumentis provided. The surgical instrument includes a housing and anendoscopic portion extending distally from the housing and defining afirst longitudinal axis. The surgical instrument also includes an endeffector disposed adjacent a distal portion of the endoscopic portion.The end effector may include an anvil assembly and a cartridge assembly.The anvil assembly is pivotally coupled to the cartridge assembly to bemovable from a first actuation position to at least one other secondactuation position. The surgical instrument further includes a firingrod having a shaft defining a second longitudinal axis, the shaft havinga cam member which is in mechanical cooperation with the anvil assemblyand is configured to move the anvil assembly from the first actuationposition to the at least one other second actuation position uponrotation of the firing rod about the second longitudinal axis.

According to another aspect of the present disclosure a surgicalinstrument is provided with a housing and an endoscopic portionextending distally from the housing and defining a first longitudinalaxis. The surgical instrument also includes an end effector disposedadjacent a distal portion of the endoscopic portion. The end effectorincludes a first jaw member and a second jaw member, the second jawmember is pivotally coupled to the first jaw member to be movable from afirst actuation position to at least one other second actuationposition. The surgical instrument further includes a firing rodincluding a shaft defining a second longitudinal axis. The shaft has acam member which is in mechanical cooperation with the second jaw memberand is configured to move the second jaw member from the first actuationposition to the at least one other second actuation position uponrotation of the firing rod about the second longitudinal axis.

According to a further embodiment of the present disclosure, a toolassembly is provided. The tool assembly includes an end effectordisposed adjacent a distal endoscopic portion. The end effector includesan anvil assembly and a cartridge assembly. The anvil assembly ispivotally coupled to the cartridge assembly to be movable from a firstactuation position to at least one other second actuation position. Thetool assembly also includes a firing rod including a shaft defining asecond longitudinal axis. The shaft has a cam member which is inmechanical cooperation with the anvil assembly and is configured to movethe anvil assembly from the first actuation position to the at least oneother second actuation position upon rotation of the firing rod aboutthe second longitudinal axis.

According to another aspect of the present disclosure, a surgicalinstrument is disclosed, which includes a housing, an endoscopic portionextending distally from the housing and an intermediate shaft having aproximal end configured for connection to a distal end of the endoscopicportion, the intermediate shaft being flexible. The instrument alsoincludes a loading unit having an end effector for performing a surgicalfunction. The loading unit includes a proximal portion configured forconnection to a distal end of the intermediate shaft.

According to a further aspect of the present disclosure, a surgicalinstrument including a housing and an endoscopic portion extendingdistally from the housing is disclosed. The housing includes at least afirst angled tube and a second angle tube, the first angled tube andsecond angled tube being rotatably movable with respect to one anotherbetween a plurality of positions including a first position defining asubstantially straight shaft and a second, fully articulated positionand an end effector disposed adjacent a distal portion of the endoscopicportion.

DESCRIPTION OF THE DRAWINGS

An embodiment of the presently disclosed powered surgical instrument isdisclosed herein with reference to the drawings, wherein:

FIG. 1 is a perspective view of a powered surgical instrument accordingto an embodiment of the present disclosure;

FIG. 2 is an exploded view of the staple cartridge and anvil or businesshead of the surgical instrument shown in FIG. 1;

FIG. 3 is a side cross-sectional view of the staple cartridge and anvilor business head of the surgical instrument shown in FIG. 1;

FIGS. 4A-B are perspective views of a shaped firing rod and cammedclamping of the stapler anvil in the open and closed positions;

FIG. 5 is a perspective view of the cam and the shaped firing rod of thesurgical instrument of FIG. 1;

FIG. 6 is an enlarged perspective view of a handle of the poweredsurgical instrument of FIG. 1;

FIG. 7 is an enlarged perspective view of a user interface of thepowered surgical instrument of FIG. 1;

FIG. 8 is a perspective view of internal components of the poweredsurgical instrument of FIG. 1;

FIGS. 9 and 10 are perspective views of the internal components of thepowered surgical instrument of FIG. 1 disposed in a first position,powered rotation;

FIG. 11 is a side view of the internal components of the poweredsurgical instrument of FIG. 1 disposed in a second position, poweredarticulation;

FIG. 12A is a perspective view including an endoscopic portion of thepowered surgical instrument of FIG. 1 according to an embodiment of thepresent disclosure;

FIG. 12B is an enlarged perspective view of the portion of the poweredsurgical instrument indicated in FIG. 12A;

FIGS. 13-14 are perspective view of the internal components of thepowered surgical instrument of FIG. 1 disposed in a third position,fire, clamp, grasp, retraction; and

FIGS. 15A-B are perspective views of articulating shaft of the distalportion of the powered surgical instrument of FIG. 1.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed powered surgical instrument arenow described in detail with reference to the drawings, in which likereference numerals designate identical or corresponding elements in eachof the several views. As used herein the term “distal” refers to thatportion of the powered surgical instrument, or component thereof,farther from the user while the term “proximal” refers to that portionof the powered surgical instrument or component thereof, closer to theuser.

A powered surgical instrument, e.g., a surgical stapler, in accordancewith the present disclosure is referred to in the figures as referencenumeral 100. Referring initially to FIG. 1, powered surgical instrument100 includes a housing 110, an endoscopic portion 140 defining alongitudinal axis A-A extending therethrough, and an end effector 160,defining a longitudinal axis B-B (illustrated substantially aligned withaxis A-A in FIG. 1) extending therethrough. Endoscopic portion 140extends distally from housing 110 and end effector 160 is disposedadjacent a distal portion 142 of endoscopic portion 140.

It is envisioned that end effector 160 is reusable and is configured toaccept a staple cartridge and/or is part of a disposable loading unit.Further details of a disposable loading unit are described in detail incommonly-owned U.S. Pat. No. 6,241,139 to Miliman, the entire contentsof which are hereby incorporated by reference herein.

The end effector 160 is coupled to the endoscopic portion 140 via amounting assembly 141. The end effector 160 may be any end effector usedin linear stapling devices, such as ENDO GIA™, GIA™, TA™, ENDO TA™, EEA™staplers sold by U.S. Surgical Corp, of Norwalk, Conn. Such endeffectors may be coupled to endoscopic portion 140 of powered surgicalinstrument 100. Mounting assembly 141 is pivotally secured to the distalportion 142 and is fixedly secured to a proximal end of tool assembly160. This allows for pivotal movement of mounting assembly 141 about anaxis perpendicular to the longitudinal axis A-A. Pivotal movement occursbetween a non-articulated position in which the longitudinal axis oftool assembly 160 is aligned with the longitudinal axis A-A and anarticulated position in which the longitudinal axis B-B of the toolassembly 160 is disposed at an angle to the longitudinal axis A-A ofendoscopic portion 140.

Referring to FIGS. 2 and 3, tool assembly 160 includes a cartridgeassembly 300 (e.g., first jaw of the tool assembly) and an anvilassembly 302 (e.g., second of the tool assembly). Anvil assembly 302includes an anvil portion 304 having a plurality of staple deformingconcavities 305 (FIG. 3) and a cover plate 306 secured to a top surfaceof anvil portion 304. Cartridge assembly 300 includes carrier 308 whichdefines an elongated support channel 310 which is dimensioned andconfigured to receive staple cartridge 312. Corresponding tabs 314 andslots 316 formed along staple cartridge 312 and elongated supportchannel 310, respectively, function to retain staple cartridge 312 at afixed location within support channel 310. A pair of support struts 318formed on staple cartridge 312 is positioned to rest on side walls ofcarrier 308 to further stabilize staple cartridge 312 within supportchannel 310.

Staple cartridge 312 includes retention slots 320 for receiving aplurality of staples or fasteners 322 and pushers 324. A plurality oflaterally spaced apart longitudinal slots 326 extends through staplecartridge 312 to accommodate upstanding cam wedges 328 of an actuationsled 330. A central longitudinal slot 332 extends along substantiallythe length of staple cartridge 312 to facilitate passage of a knifeblade (not explicitly shown).

FIGS. 4A-B and 5 show a firing rod 402 for articulation and actuation ofthe tool assembly 160. The firing rod 402 includes a proximal shaft 404which extends the length of the endoscopic portion 140 and the distalportion 142 and a distal shaft 406 which is disposed within the toolassembly 160. The proximal shaft 404 and the distal shaft 406 arepivotally linked via a pivot member 410 which passes through bores (notexplicitly shown) within the distal end of the proximal shaft 404 andthe proximal end of the distal shaft 406. Pivotal movement occursbetween a non-articulated position in which the longitudinal axis ofdistal shaft 406 is aligned with the longitudinal axis K-K and anarticulated position in which the longitudinal axis L-L of the tooldistal shaft 406 is disposed at an angle to the longitudinal axis K-K ofproximal shaft 404. The firing rod 402 may be formed from a rigid and/orflexible material. Forming the firing rod 402 from a flexible materialobviates the need for pivot member 410 as the proximal shaft 404 canpivot with respect to the distal shaft 406 by nature of the flexibilityof the material. It is envisioned that other pivoting mechanisms may beused, such as plastic or rubber bands interconnecting the proximal anddistal portions 404 and 406.

The proximal shaft 404 and the distal shaft 406 of the firing rod 402incorporate a plurality of surface features or shapes along the lengththereof. In embodiments, the firing rod 402 has a generally cylindricalstructure with a non-circular cross-section (e.g., hexagonal, octagonal,star-shaped, oval, etc.) It is also envisioned the firing rod 402 mayinclude one or more curved shapes (e.g., helix, screw, etc.) Thesestructures allow for gripping of the firing rod 402 and rotation thereofto actuate the tool assembly 160.

The firing rod 402 is disposed within a passage (not explicitly shown)of the endoscopic portion 140 and the distal portion 142, the passagehas the same cross-sectional profile as the firing rod 402 such that thefiring rod 402 is in mechanical cooperation with the passage but cansimultaneously freely slide therein. This is especially useful if thefiring rod 402 is formed from a flexible material since this preventsdeformation of the firing rod 402 within the passage.

The firing rod 402 is configured for opening and closing of the anvilassembly 302 as well as pushing actuation sled 330 through longitudinalslots 326 of staple cartridge 312 to advance cam wedges 328 intosequential contact with pushers 324 to staple tissue. The firing rod 402is configured to be selectively moved between a plurality of positions.In certain embodiments, the firing rod 402 is moved between at least twopositions. The first position, illustrated in FIG. 4A, enables openingand closing of the anvil assembly 302 via rotation of the firing rod 402about longitudinal axis K-K; the second position, illustrated in FIG.4B, enables advancement of pushers 324 to push fasteners 322 throughtissue.

In FIG. 4A the firing rod 402 is shown in the first position. The distalshaft 406 of the firing rod 402 includes a cam member 408, which isshown as a dual cam, disposed thereon. In the first position, the cammember 408 is positioned in a plane perpendicular to the longitudinalaxis L-L at the distal end of the anvil assembly 302. During operation,the firing rod 402 is rotated, which causes rotation of the cam member408. As the cam member 408 is rotated, the proximal end of the anvilassembly 302 is pushed upwards by the perpendicular displacement of thecam member 408 thereby closing the anvil assembly 302 against thecartridge assembly 300 (FIG. 4B).

The anvil assembly 302 is pivotally coupled to the cartridge assemblyvia tabs 332 which extend downwards therefrom. The tabs 332 fit intocorresponding slots (not explicitly shown) to provide a hinge point forthe anvil assembly 332 to pivot thereabout. This allows the anvilassembly 302 to pivot with respect to the cartridge assembly 300. As thefiring rod 408 is rotated further the anvil assembly 302 reverts to openposition via one or more biasing members (e.g., springs) pushing upwardson the opposite side of the tabs 332.

Various types of cams may be used to open and close the anvil assembly302, such as single cams, or multi-cams. Other cam shapes may also beutilized which have a less aggressive angle utilizing full 360° ofrotation allowing the anvil assembly 302 to reach full displacement at amore gradual rate. Angle of rotation of the firing rod 402 varies withthe type of cam being used, such as for the cam member 408, the firingrod 402 is rotated 90° in order to actuate the anvil assembly 302. Inother words, the cam member 402 allows for maximum displacement of theanvil assembly 302 under 90°. It is also envisioned that the firing rod402 may be rotated in either direction, clockwise or counterclockwise,to actuate the anvil assembly 302.

While in the first position the firing rod 402 is prevented fromlongitudinal movement in the distal direction by the proximal end of thecartridge assembly 300 and the cam member 408. The walls of the supportchannel 310 act as a stop member when the firing rod 402 is moved in thedistal direction. Once the firing rod 402 is rotated into secondposition as shown in FIG. 4B, the firing rod 402 can be advanceddistally to push the actuation sled 330 through the staple cartridge 312since the firing rod 402 is no longer stopped by the distal end of thecartridge assembly. The firing rod 402 is movable through the cam member408, the interface between an aperture through the cam member 408 andthe firing rod 402 being shaped to allow a telescoping movement, butalso shaped so that the cam member 408 and firing rod 402 rotatetogether. For example, the cam member 408 and firing rod 402 have ahexagonal shaped interface as shown in FIGS. 4A and 4B. Other shapes,such as helical, star shaped, splined, oval, slotted, and octagonal, canbe used.

During operation of surgical stapler, the firing rod 402 abuts actuationsled 330 and pushes actuation sled 330 through longitudinal slots 326 ofstaple cartridge 312 to advance cam wedges 328 of sled 330 intosequential contact with pushers 324. Pushers 324 translate verticallyalong cam wedges 328 within fastener retention slots 320 and urgefasteners 322 from retention slots 320 into staple deforming cavities304 (FIG. 4) of the anvil assembly 302.

With reference to FIGS. 6 and 7, an enlarged view of housing 110 isillustrated according to an embodiment of the present disclosure. In theillustrated embodiment, housing 110 includes a handle portion 110 bhaving two buttons 114 a and 114 b. Handle portion 110 b, which definesa handle axis H-H, is shown having indentations 116 that correspond tofingers of a user. Each button 114 a and 114 b is shown as beingdisposed on an indentation 116 to facilitate its depression by a user'sfinger.

A proximal area 118 of housing 110 includes a user interface 120. In theillustrated embodiment, user interface 120 includes a screen 122 and atleast one switch 124 (seven switches 124 a-124 g are shown). Screen 122displays readable information thereon, including status information ofpowered surgical instrument 100 in an embodiment.

FIG. 7 shows user interface 120 including screen 122 and seven switches124 a-124 g. In the illustrated embodiment, user interface displays the“mode” (e.g., rotation, articulation or actuation), which may becommunicated to user interface 120 via shift sensor 224, “status” (e.g.,angle of articulation, speed of rotation, or type of actuation) and“feedback,” such as whether staples have been fired. Switch 124 a isshown having an “M,” standing for mode, which may be used to positiondrive gear 200 via shift motor 220 for selecting between rotation,articulation, grasping, clamping and firing. It is also envisioned thatswitch 124 a can be used to let a user input different tissue types, andvarious sizes and lengths of staple cartridges.

Switches 124 b-124 e are shown with arrows thereon and may be used forselecting the direction, speed and/or torque at which drive gear 200 isrotated by drive motor 210. It is also envisioned that at least oneswitch 124 can be used for selecting an emergency mode that overridesvarious settings. Further, switches 124 f and 124 g are illustratedhaving an “N” and a “Y” thereon. It is envisioned that switches 124 fand 124 g may be used for helping a user navigate user interface menusand select various setting of powered surgical instrument 100. Theindicia on switches 124 a-124 g and their respective functions are notlimited by what is shown in the accompanying figures, as deviationstherefrom are contemplated and within the scope of the presentdisclosure. Additionally, and with reference to FIGS. 1 and 6, buttons114 a and 114 b may be used for starting and/or stopping movement ofdrive motor 210 and/or shift motor 220 and the like.

FIGS. 8-14 illustrate various internal components of powered surgicalinstrument 100, including a drive gear 200, a drive motor 210 and ashift motor 220. Power is provided via a battery pack 401 (or fuel cellassembly). Other power-supplying means are also contemplated (e.g.,electrical transformers coupled to conventional electrical powersupplies).

As shown in FIG. 8, the drive gear 200, the drive motor 210 and thebattery pack 401 are disposed within the housing 110, specifically aproximal housing portion 110 b. It is envisioned that these componentsmay also be located within or closer to a distal housing portion 110 a.The primary or a secondary motor, transmission, and/or the batteries maybe disposed in the endoscopic portion 140.

Drive gear 200 is rotatable about a drive gear axis C-C extendingtherethrough (FIG. 8) and is selectively movable along drive gear axisC-C. Drive motor 210 is disposed in mechanical cooperation with drivegear 200 and is configured to rotate drive gear 200 about drive gearaxis C-C. Shift motor 220 is disposed in mechanical cooperation via thedrive motor 210 with drive gear 200 and is configured to translate drivegear 200 axially along drive gear axis C-C.

Shift motor 220 is configured to selectively move drive gear 200 betweena plurality of positions. In embodiments, the drive gear 200 is movedbetween three positions. The first position, illustrated in FIGS. 9 and10, enables rotation of end effector 160; the second position,illustrated in FIG. 11, enables articulation of end effector 160; andthe third position, illustrated in FIGS. 13-14, enables actuation ofpowered surgical instrument 100.

In the embodiment illustrated in FIG. 9, shift motor 220 is shownincluding a two-part housing 226. Each part 226 a and 226 b of two-parthousing 226 are slidably engaged with each other. It is envisioned thatpart 226 a is rigidly secured to a drive motor casing 212, while part226 b is affixed to drive motor 210 and is translatable within housing110. Additionally, a wiring slot 228 may be included to allow for wires(not explicitly shown) to pass from transducer 420 towards userinterface 120, for example.

A cut away of the drive motor casing 212, at least partially surroundingdrive motor 210, is illustrated in FIGS. 8-11. Drive motor casing 212includes slots 214 a, 214 b and 214 c therein. Each slot 214 isconfigured to mate with a position lock 216 to maintain drive gear 210in a desired position. In FIG. 9, position lock 216 is shown mated withslot 214 a-corresponding to drive gear 200 being in its first position.In FIG. 11, position lock 216 is shown mated with slot 214b—corresponding to drive gear 200 being in its second position. FIGS. 13and 14 illustrate position lock 216 mated with slot 214 c—correspondingto drive gear 200 being in its third position. Position lock 216, in theillustrated embodiments, is spring-loaded and biased against the drivemotor casing 212, which maintains drive motor 210 is a desired position.

In the illustrated embodiments, shift motor 220 is located proximally ofdrive motor 210 and is configured to translate drive motor 210 alongdrive gear axis C-C between its first, second and third positions.Referring to FIG. 14, shift motor 220 is illustrated being driven by ashift screw 222 in conjunction with an internally-threaded screw housing223, in accordance with a disclosed embodiment. It is further disclosedthat a shift sensor 224 (See FIG. 8) (e.g., micro switch oroptical/ferromagnetic proximity sensor activate by position lock 216),disposed adjacent position lock 216, electrically communicates with atleast one switch 124 to start or stop shift motor 220 and/or providesfeedback relating to the position of drive motor 210 (e.g., position ofdrive motor 210, such as “rotation,” is displayed on screen 122 of userinterface 120).

With reference to FIGS. 9 and 10, the first position of drive gear 200is illustrated. Ring gear 230 is disposed within housing 110, whereinrotation of ring gear 230 causes rotation of endoscopic portion 140, endeffector 160 and a distal housing portion 110 a. Distal housing portion110 a is disposed distally of a proximal housing portion 110 b. Thehousing portion 110 a includes a guide channel 232 which is peripherallydisposed therein and is configured to interface with a correspondingflange 234 which is peripherally disposed within the proximal housingportion 110 b. In particular, the flange 234 is configured to slidablyrotate within the guide channel 232 thereby allow for rotation of thehousing portion 110 a with respect to proximal housing portion 110 b. Inan embodiment, ring gear 230 is rigidly secured within distal housingportion 110 a and is matingly engagable with drive gear 200. Thus,rotation of drive gear 200 causes rotation of the ring gear 230 and thehousing portion 110 a along with the end effector 160 about thelongitudinal axis B-B.

In FIG. 6, a lip 235 is shown which isolates a user's hand fromrotatable distal housing portion 110 a. It is envisioned that aplurality of washers or ball-bearings (possibly made from syntheticresinous fluorine-containing polymers sold under the trademark TEFLON®)is disposed between distal housing portion 110 a and proximal housingportion 110 b to reduce the rotational friction therebetween.

With continued reference to the embodiment illustrated in FIG. 10, aplurality of detents 231 is disposed around a surface 233 of distalhousing portion 110 a. A tab 237 is shown disposed on proximal housingportion 110 b. In a disclosed embodiment, tab 237 is distally biased(e.g., via tab spring 239) and in mechanical cooperation with at leastone of plurality of detents 231. The combination of detents 231 and tab237 helps secure distal housing portion 110 a in a rotational positionwith respect to proximal housing portion 110 b.

In FIG. 11, drive gear 200 is illustrated in its second position, asposition lock 216 is aligned with slot 214 b. Here, drive gear 200 ismatingly engaged with an articulation gear 240, which is disposed atleast partially within housing 110. Rotation of articulation gear 240causes end effector 160 to move from its first position, wherelongitudinal axis B-B is substantially aligned with longitudinal axisA-A, towards its second position, wherein longitudinal axis B-B isdisposed at an angle to longitudinal axis A-A.

In the illustrated embodiments and with specific reference to FIGS. 11and 12, articulation of end effector 160 is affected by an articulationgear 240, an articulation screw 242, an articulation linkage 244 and atleast one articulation rod 260. More specifically, articulation gear 240is rigidly mounted to articulation screw 242, such that as articulationgear 240 is rotated by rotation of drive gear 200 while in its secondposition, articulation screw 242 also rotates. A plurality of bearings262 is illustrated at various locations on articulation screw 242 tofacilitate the retaining and aligning of articulation screw drive 242 aswell as reducing the friction between articulation screw 242 and housing110, for example.

With continued reference to FIG. 11, articulation screw 242 includes athreaded portion 246, which extends through an internally-threadedportion 248 of articulation linkage 244. This relationship betweenarticulation screw 242 and articulation linkage 244 causes articulationlinkage 244 to move distally and/or proximally (in the directions ofarrows F and G) along threaded portion 246 of articulation screw 242upon rotation of articulation screw 242. For example, as articulationscrew 242 rotates in a first direction (e.g., clockwise), articulationlinkage 244 move proximally, and as articulation screw 242 rotates in asecond direction (e.g., counter-clockwise), articulation linkage 244move distally.

At least one articulation arm 250 is shown extending from articulationlinkage 244. In an embodiment, articulation arm 250 is rigidly connectedto articulation rod 260 and it is envisioned that more than onearticulation arm 250 is connectable to more than one articulation rod260. As articulation linkage 244 is translated distally and/orproximally in response to rotation of articulation gear 240,articulation rod(s) 260 is also translated distally and/or proximally(in the directions of arrows F and G, along longitudinal axis A-A) inresponse thereto. Any combinations of limits switches, proximity sensors(e.g., optical and/or ferromagnetic), linear variable displacementtransducers and shaft encoders (disposed within housing 110, forinstance) may be utilized to control and/or record the location ofarticulation linkage 244 and/or articulation angle of end effector 160and/or position of an actuation rod 306 as discussed below withreference to FIGS. 13 and 14.

With reference to FIGS. 12A and 12B, articulation rod 260 is shownextending through at least a portion of endoscopic portion 140 and inmechanical cooperation with a linkage rod 264. Thus, linkage rod 264similarly moves along longitudinal axis A-A upon rotation ofarticulation gear 240. A distal portion 266 of linkage rod 264 is inmechanical cooperation with end effector 160, such that proximal anddistal movement of linkage rod 264 causes end effector 160 to move fromits first position towards its second position about pivot P. Morespecifically, and for illustrative purposes, as linkage rod 264 movesdistally, end effector 160 is articulated in the direction of arrow Hand as linkage rod 264 is translated proximally, end effector 160 isarticulated in the direction of arrow I. It is also envisioned that aportion of articulation rod 260 is in mechanical cooperation with endeffector 160 to affect articulation thereof. Further details ofproviding articulation to end effector 160 are described in detail incommonly-owned U.S. Pat. No. 6,953,139 to Milliman et al., the contentsof which are hereby incorporated by reference in their entirety.

With reference to FIGS. 13 and 14, drive gear 200 is illustrated in itsthird position, with position lock 216 aligned with slot 214 c. Thedrive gear 200 is matingly engaged with an actuator gear 300, which isdisposed at least partially within housing 110. More specifically, a setof teeth 202 disposed on a face 204 (FIG. 8) of drive gear 200 matinglyengage actuator gear 300 to provide at least one of grasping tissue,clamping tissue, firing of end effector 160 (e.g., stapling and cutting)and retracting elements to their original position.

With reference to FIG. 13, a drive motor shaft 218 is shown extendingfrom drive motor 210 and being connected to drive gear 220. A fastener(not explicitly shown in this embodiment) may be used to retain drivegear 220 on drive motor shaft 218. Drive motor shaft 218 is rotated bydrive motor 210, thus resulting in rotation of drive gear 220. Drivemotor shaft 218 is shown having a flat portion 219 (more than one flatportions 219 may be included), which allows “play” or “rotational float”between drive gear 220 and drive motor shaft 218 to facilitate toothalignment and to help enable drive gear 220 to shift between positions.FIG. 13 also illustrates a bearing 309 disposed within housing 110 andat least partially surrounding drive tube 303. Bearing 309 facilitatesrotation of drive tube 303 and aligns drive tube 303 through endoscopicportion 140.

In FIG. 14, a transducer 420 is shown adjacent drive motor 210 and shiftmotor 220. Transducer 420 (e.g., a force or pressure transducer) maymeasure and/or control the force required for the desired pressure onactuator gear 330. Transducer 420 may be in communication with portionsof user interface 120, which may provide feedback to a user.

With reference to FIGS. 13 and 14, a drive tube 303 and an actuation rod307 are also included. Drive tube 303 is rigidly attached to actuatorgear 300. In an embodiment of the disclosure, actuation rod 307 extendsat least to distal portion 142 of endoscopic portion 140 and ismechanically coupled to the firing rod 402. In response to rotation ofdrive gear 200, actuator gear 300 and drive tube 303 also rotate. Asdrive tube 303 rotates, the actuation rod 307 is driven forward by thethreaded bung 360. Actuation rod 307 is prevented from rotation byflat/non-round features 380 which are mated to the tube housing crosssection 266. When unlocked, rotation of actuation rod 307 rotates thefiring rod 402 which closes the anvil assembly 302 of end effector 160to grasp or clamp tissue held therebetween. Further details of firingend effector 160 (or actuation) are described in detail incommonly-owned U.S. Pat. No. 6,953,139 to Milliman et al., the entirecontents of which are hereby incorporated by reference herein.

The firing rod 402 can be advanced distally to advance the actuationsled 330 either manually or automatically (e.g., via motorizedmechanisms). An example of a powered stapler configured for advancing afiring rod to push fasteners through tissue is illustrated in acommonly-owned U.S. patent application entitled “Powered SurgicalStapling Device” by Marczyk, U.S. application Ser. No. 11/724,744, filedMar. 15, 2007, the disclosure of which is hereby incorporated byreference herein in its entirety.

As discussed above, the firing rod 402 is disposed within the endoscopicportion 140 and the distal portion 142. Therefore, in embodiments wherethe firing rod 402 is formed from a flexible material it is desirable toprovide flexible endoscopic portion 140 and distal portion 142. As shownin FIGS. 15A-B, the endoscopic and distal portions 140, 142 are shown asa flexible shaft 500. The flexible shaft 500 includes a plurality ofinterconnected angled outer tubes 501 and 502. FIG. 15A shows theflexible shaft in a non-articulated formation and FIG. 15B shows theflexible shaft 500 in full articulation formation. When the flexibleshaft 500 is straight, narrow sections of the tubes 501 alternate withthe wide sections of the tubes 502 as shown in FIG. 15A. When theflexible shaft 500 is fully articulated, the short sides and the widesides of the tubes 501 and 502 are aligned as shown in FIG. 15B.

The flexible shaft 500 also includes a proximal drive end cap 503 whichis in mechanical cooperation with the drive gear 200 and a distal endcap 504 which is in communication with another component of the surgicalstapler 10 (e.g., the tool assembly 160 or the distal portion 142depending where the flexible shaft 500 is disposed). The drive end cap503 has only one angled face and is turned by the drive gear 200. Theend cap 504 is fixed from rotation and also has one angled face andincludes an internal stop member for mating with the neighboring tube.

The tubes 500 are mated together by a step which is disposed on theedges of inner surfaces of the tubes 500. The tubes 500 also includestop members at 180 degree positions which interface with neighboringtubes to turn against frictional forces. Each of the tubes 501 and 502are angled by the same amount on corresponding mating faces and includealternative grooves and ribs which interlock the tubes 501 and 502.

Articulation is achieved by rotation of the tubes 501 and 502 eithersequentially or independently. The drive end cap 503 is rotatedcontinuously until the flexible shaft 500 has attained desiredarticulation position. As the drive end cap 503 is rotated, each tube isrotated correspondingly until the tube reached 90 degree rotation andthen locks with the subsequent tube which then begins rotation of thesubsequent tube, etc. Use of the flexible shaft 500 in manual ormotor-driven instruments is contemplated. A designated motor, or a motordriving multiple functions of the instrument may be used. One of thepositions of the shift motor 220 can engage a ring gear operativelyconnected to proximal drive end cap 503 so that drive gear 200 can driverotation of the proximal drive end cap 503.

In further embodiments, the endoscopic portion 140 is configured tointerchangeably mate with a variety of surgical end effectors including,but not limited to, circular surgical staplers, linear surgicalstaplers, and others. The endoscopic portion 140 may be relativelyrigid, flexible (such as the shaft shown in FIGS. 15A and 15B) and/orarticulating.

In certain embodiments, a digital control module (DCM) is desirablyincluded in the housing 110 and can be configured and arranged tocontrol or help control the operation of shift motor 220 and/or drivemotor 210 to respond to the monitored information. Pulse modulation,which may include an electronic clutch, may be used in controlling theoutput. For example, the DCM can regulate the voltage or pulse modulatethe voltage to adjust the power and/or torque output to prevent systemdamage or optimize energy usage. An electric braking circuit may be usedfor controlling the drive motor 210 and/or shift motor 220, which usesthe existing back electromotive force (EMF) of rotating drive motor 210to counteract and substantially reduce the momentum of drive gear 200.The electric braking circuit may improve the control of drive motor 210and/or shift motor 220 for stopping accuracy and/or shift location ofpowered surgical instrument 100. Sensors for monitoring components ofpowered surgical instrument 100 and to help prevent overloading ofpowered surgical instrument 100 may include thermal-type sensors, suchas thermal sensors, thermistors, thermopiles, thermo-couples and/orthermal infrared imaging and provide feedback to the DCM. The DCM maycontrol the components of powered surgical instrument 100 in the eventthat limits are reached or approached and such control can includecutting off the power from the battery pack 400, temporarilyinterrupting the power or going into a pause mode, pulse modulation tolimit the energy used, and the DCM can monitor the temperature ofcomponents to determine when operation can be resumed. The above uses ofthe DCM may be used independently of or factored with current, voltage,temperature and/or impedance measurements.

An identification system may also be included to determine andcommunicate to the DCM various information, including the speed, power,torque, clamping, travel length and strength limitations for operatingthe particular end effector 160. The DCM may also determine theoperational mode and adjust the voltage, clutch spring loading and stoppoints for travel of the components. More specifically, theidentification system may include a component (e.g., a microchip,emitter or transmitter) in end effector 160 that communicates (e.g.,wirelessly, via infrared signals, etc.) with the DCM, or a receivertherein. It is also envisioned that a signal may be sent via firing rod,such that the firing rod functions as a conduit for communicationsbetween the DCM and end effector 160. The identification systemcommunicates with the DCM information concerning the surgicalinstrument, such as, for example, the type of end effector attached tothe surgical instrument and/or the status of the end effector.

In a disclosed embodiment, at least some of the information monitored bythe various sensors in powered surgical instrument 100 may be providedto a video screen or monitoring system in an operating room. Forinstance, the data may be transmitted to a receiver for the operatingroom monitoring system from a communication transmitter incorporated inor associated with powered surgical instrument 100, via technologyincluding Blue Tooth, ANT3, KNX, Z Wave, X10, wireless USB, WiFi, IrDa,Nanonet, Tiny OS, ZigBee, radio, UHF and VHF. Such features mayfacilitate monitoring by the user of powered surgical instrument 100 orother operating room or hospital personnel or remotely located persons.

It will be understood that various modifications may be made to theembodiments disclosed herein. For example, a shorter elongated tubularportion containing more or less coil fasteners may be provided forgreater ease of handling during open surgery. Various articulations maybe provided along the length of the elongated tubular portion tofacilitate positioning of the coil fastener applier within the body.Additionally various configurations of the drive rod and slots orfastener retaining structure may be provided to accommodate varioustypes of rotary fasteners. Therefore, the above description should notbe construed as limiting, but merely as exemplifications of variousembodiments. Those skilled in the art will envision other modificationswithin the scope and spirit of the claims appended hereto.

1. A surgical instrument, comprising: a housing; an endoscopic portionextending distally from the housing and defining a first longitudinalaxis; an end effector disposed adjacent a distal portion of theendoscopic portion, the end effector including an anvil assembly and acartridge assembly, the anvil assembly is pivotally coupled to thecartridge assembly between a first open position spaced from thecartridge assembly and a second position in approximation with thecartridge assembly; a firing rod defining a second longitudinal axis,and a cam member rotatable with the firing rod, the cam member being inmechanical cooperation with the anvil assembly and being configured tomove the anvil assembly between the first position and the secondposition.
 2. A surgical instrument according to claim 1, wherein thefiring rod includes a proximal shaft member disposed within the endeffector and a distal shaft member disposed within the endoscopicportion.
 3. A surgical instrument according to claim 2, wherein theproximal shaft member and the distal shaft member are pivotally linked.4. A surgical instrument according to claim 2, wherein at least one ofthe proximal shaft member and the distal shaft member is flexible.
 5. Asurgical instrument according to claim 2, wherein the proximal shaft andthe distal shaft include at least one surface feature along the lengththereof.
 6. A surgical instrument according to claim 5, wherein the atleast one surface feature is selected from the group consisting of anon-circular cross-section and a curved shape.
 7. A surgical instrumentaccording to claim 1, wherein the end effector defines a thirdlongitudinal axis, the end effector being movable from a firstarticulation position where the second longitudinal axis issubstantially aligned with the first longitudinal axis to at least asecond articulation position where the third longitudinal axis isdisposed at an angle to the first longitudinal axis.
 8. A surgicalinstrument according to claim 1, wherein the end effector includes anactuation sled disposed therein, the actuation sled abutting a distalend of the distal shaft of the firing rod, such that when the firing rodis advanced in a distal direction, the actuation sled comes intosequential contact with a plurality of pushers which translatevertically and urge a plurality of corresponding fasteners into theanvil assembly.
 9. A surgical instrument according to claim 8, whereinthe firing rod is prevented from advancing in the distal directionunless the firing rod is rotated about the second longitudinal axis tomove the anvil assembly from the first actuation position to the atleast one other second actuation position.
 10. A surgical instrument,comprising: a housing; an endoscopic portion extending distally from thehousing and defining a first longitudinal axis; an end effector disposedadjacent a distal portion of the endoscopic portion, the end effectorincluding a first jaw member and a second jaw member, the second jawmember is pivotally coupled to the first jaw member to be movable from afirst actuation position to at least one other second actuationposition; and a firing rod including a shaft defining a secondlongitudinal axis, the shaft having a cam member which is in mechanicalcooperation with the second jaw member and is configured to move thesecond jaw member from the first actuation position to the at least oneother second actuation position upon at least one of rotation andlongitudinal translation of the firing rod about the second longitudinalaxis.
 10. A surgical instrument according to claim 9, wherein the firingrod includes a proximal shaft member disposed within the end effectorand a distal shaft member disposed within the endoscopic portion.
 11. Asurgical instrument according to claim 10, wherein the proximal shaftmember and the distal shaft member are pivotally linked.
 12. A surgicalinstrument according to claim 10, wherein the proximal shaft and thedistal shaft include at least one surface feature along the lengththereof.
 13. A surgical instrument according to claim 12, wherein the atleast one surface feature is selected from the group consisting of anon-circular cross-section and a curved shape.
 14. A surgical instrumentaccording to claim 10, wherein the end effector defines a thirdlongitudinal axis, the end effector being movable from a firstarticulation position where the second longitudinal axis issubstantially aligned with the first longitudinal axis to at least asecond articulation position where the third longitudinal axis isdisposed at an angle to the first longitudinal axis.
 15. A toolassembly, comprising: an end effector disposed adjacent a distalendoscopic portion of the, the end effector including an anvil assemblyand a cartridge assembly, the anvil assembly is pivotally coupled to thecartridge assembly to be movable from a first actuation position to atleast one other second actuation position; and a firing rod including ashaft defining a second longitudinal axis, the shaft having a cam memberwhich is in mechanical cooperation with the anvil assembly and isconfigured to move the anvil assembly from the first actuation positionto the at least one other second actuation position upon rotation of thefiring rod about the second longitudinal axis.
 16. A tool assemblyaccording to claim 15, wherein the firing rod includes a proximal shaftmember disposed within the end effector and a distal shaft memberdisposed within the endoscopic portion.
 17. A tool assembly according toclaim 16, wherein the proximal shaft member and the distal shaft memberare pivotally linked.
 18. A tool assembly according to claim 16, whereinthe proximal shaft and the distal shaft include at least one surfacefeature along the length thereof.
 19. A tool assembly according to claim18, wherein the at least one surface feature is selected from the groupconsisting of a non-circular cross-section and a curved shape.
 20. Atool assembly according to claim 15, wherein the end effector defines athird longitudinal axis, the end effector being movable from a firstarticulation position where the second longitudinal axis issubstantially aligned with the first longitudinal axis to at least asecond articulation position where the third longitudinal axis isdisposed at an angle to the first longitudinal axis.
 21. A tool assemblyaccording to claim 15, wherein the end effector includes an actuationsled disposed therein, the actuation sled abutting a distal end of thedistal shaft of the firing rod, such that when the firing rod isadvanced in a distal direction, the actuation sled comes into sequentialcontact with a plurality of pushers which translate vertically and urgea plurality of corresponding fasteners into the anvil assembly.
 22. Atool assembly according to claim 21, wherein the firing rod is preventedfrom advancing in the distal direction unless the firing rod is rotatedabout the second longitudinal axis to move the anvil assembly from thefirst actuation position to the at least one other second actuationposition.
 23. A surgical instrument, comprising: a housing; anendoscopic portion extending distally from the housing; an intermediateshaft having a proximal end configured for connection to a distal end ofthe endoscopic portion, the intermediate shaft being flexible; and aloading unit having an end effector for performing a surgical function,the loading unit having a proximal portion configured for connection toa distal end of the intermediate shaft.
 24. The surgical instrument ofclaim 23, wherein the housing has a power motor and a drive shaft fordriving the end effector.
 25. The surgical instrument of claim 24,wherein the housing has a power source connected to the power motor. 26.The surgical instrument of claim 24, further including a sensor fordetermining the surgical function of the loading unit.
 27. The surgicalinstrument of claim 26, further including a digital controller forreceiving information regarding the surgical function of the loadingunit.
 28. The surgical instrument of claim 27, wherein the digitalcontroller is connected to the power motor.
 29. The surgical instrumentof claim 28, wherein the digital controller controls the output of thepower motor.
 30. A surgical instrument, comprising: a housing; anendoscopic portion extending distally from the housing and having atleast a first angled tube and a second angle tube, the first angled tubeand second angled tube being rotatably movable with respect to oneanother between a plurality of positions including a first positiondefining a substantially straight shaft and a second, fully articulatedposition; and an end effector disposed adjacent a distal portion of theendoscopic portion.
 31. The surgical instrument of claim 30, wherein theend effector is removably connected to the endoscopic portion.
 32. Thesurgical instrument of claim 31, wherein the end effector including ananvil assembly and a cartridge assembly, the anvil assembly is pivotallycoupled to the cartridge assembly to be movable between a first openposition spaced from the cartridge assembly and a second position inapproximation with the cartridge assembly. The surgical instrument ofclaim 31, wherein the end effector defines a circular stapling assembly.34. The surgical instrument of claim 30, further comprising a drivemotor is disposed in the housing and operably connected to theendoscopic portion.
 35. The surgical instrument of claim 34, wherein thefirst angled tube is rotatably driven by the drive motor, to rotate thefirst angled tube with respect to the second angled tube.
 36. Thesurgical instrument of claim 34, further comprising a digital controlmodule configured to control operation of the drive motor.
 37. Thesurgical instrument of claim 36, wherein the end effector includes acomponent in communication with the digital control module, thecomponent communicating to the digital control module the type of endeffector.
 38. The surgical instrument of claim 36, wherein the digitalcontrol module is part of an operating room monitoring system.
 39. Thesurgical instrument of claim 30, further comprising a drive motormovable into connection with the endoscopic portion.
 40. The surgicalinstrument of claim 39, wherein the first angled tube is rotatablydriven by the drive motor, to rotate the first angled tube with respectto the second angled tube.